In-Home Health Care - All posts tagged In-Home Health Care

Public-sector unions got dinged but dodged a bullet today when the Supreme Court ruled in Harris v. Quinn in a case that centered on home health aides in Illinois.

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Most Americans want to age in place.

In a 5 to 4 vote, the court ruled that the plaintiffs–home health aides compensated by the state’s Medicaid program–need not be forced to pay dues to a union they don’t want to join. The aides had argued that such paying dues would amount to a violation of their First Amendment rights, since by paying they’d be supporting an organization whose positions they might not agree with.

With an annual outlay of more than $2 trillion, the U.S. outspends every other nation, per capita, on health care expenditures. Yet it’s been widely noted that we hardly reap the health benefits of this outsized spending, as the U.S. lags most developed countries on life expectancy and other measures. A new study by the RAND Corporation calls for curbing costly medical technologies that don’t really improve health, and for encouraging ones that do.

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Wanted: a home run in medical innovation.

The study advocates examining medical technologies to ensure that some of the priciest advances reap large enough health benefits to justify their added expense. “The financial incentives for innovators, investors, physicians, hospitals and patients often lead to decisions that increase spending with little payback in terms of health improvement,” said Steven Garber, lead author of the study and a senior economist at RAND, a nonprofit research organization, in a press release.

Whether you’re in market for long-term-care insurance or not, you owe it to yourself to take a look at some new data that documents the cost of long-term-care—both at home and in assisted living facilities and nursing homes.

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This’ll cost you around $45,000 a year.

The long-term-care industry’s biggest player, Genworth Financial Inc.
/quotes/zigman/340124/delayed/quotes/nls/gnwGNW, has been tracking this data for 11 years in its annual Cost of Care Survey. Genworth, of course, stands to benefit when consumers decide to buy long-term-care coverage, but outside observers regard the insurer’s data as a useful resource to help you gauge the future cost and figure out whether to buy a policy.

According to academics at Georgetown and Penn State universities, about 70% of individuals 65 and older will need long-term care—whether at home or in an assisted-living facility or nursing home. On average, women need 3.7 years of care, while men need 2.2 years. For 11% of men and 28% of women, the duration is five or more years.

We all know that the perils of being a couch potato–or a desk jockey–include an expanding waistline and back pain. But recent research suggests that too much sitting is linked to major disability after age 60.

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He would do well to find a more active hobby.

The study, by researchers at the Northwestern University Feinberg School of Medicine, was the first to show sedentary behavior is its own risk factor for disability, independent of lack of exercise. In other words, it suggests moderate exercise isn’t going to ameliorate the negative effects of too much sedentary time. It also implies that the benefits of an active retirement extend beyond the satisfaction of checking items off your bucket list.

Home-health aides who care for the elderly and disabled belong to one of the nation’s fastest-growing job categories—and do some of the toughest jobs. But an attempt by the state of Illinois to boost pay for health aides has been caught up in a wider legal battle over public employees’ right to opt out of union membership. That fight has now reached the Supreme Court , which heard arguments yesterday in the case, Harris v. Quinn. (Read a transcript of the arguments here.)

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Higher wages and union dues may go hand-in-hand.

The case has more to do with the politics of labor than with the economics of caring for seniors. In brief: Opponents of the Illinois law and others like it object that they force public-sector employees to pay union dues that could be used to support political causes that the employees don’t agree with—a potential violation of their First Amendment rights. But some of the details of the case illustrate the legal and financial gray area where many home-health workers operate.

Researchers have long sought ways to stop the relentless and devastating progression of Alzheimer’s disease. While a few prescription medications exist, none has proved to be a breakthrough. A study published recently in JAMA, the Journal of the American Medical Association, suggests certain patients might benefit from a more humble source of treatment.

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There’s no breakthrough Alzheimer’s drug yet.

On the New York Times’ New Old Age blog, Pam Belluck recently wrote about the findings, which suggested that antioxidant-rich vitamin E prolongs some Alzheimer’s patients’ ability to perform daily tasks. The study analyzed 561 mostly male participants, who had mild to moderate Alzheimer’s disease and were patients at Veterans Affairs medical centers. It found that those who took a high dose of vitamin E over a period of two years experienced a six-month slowdown in the progression of certain symptoms..

Do you remember your parents’ Social Security numbers but not your own? Are you on a first-name basis with your hospital security guard? Then you’re probably a caregiver, according to a recent AARP video featuring Jeff Foxworthy, the comedian known for his “You Might Be a Redneck If” routine.

Know the guard’s name? Maybe you’re a caregiver.

November is National Family Caregivers Month, a designation started by the Caregiver Action Network (formerly known as the National Family Caregivers Association) and recognized by each president since Bill Clinton in 1997. The movement aims to recognize and thank the family caregivers who provide an estimated $450 billion worth of uncompensated care to loved ones annually.

The report focuses on foreign-educated and foreign-born health care workers, a group that includes doctors, nurses and direct care workers who often assist the elderly. According to a recent story in Bloomberg, by 2020 the U.S. will require 1.6 million more direct-care workers than in 2010, based on an analysis of Bureau of Labor Statistics data by the New York-based Paraprofessional Healthcare Institute. That would represent a 48% increase for nursing, home-health and personal-care aides over the decade.

Home health care is an industry that’s emblematic of the problems of the 21st-century economy: It’s simultaneously fast-growing and low-paid. But a new rule unveiled by the Department of Labor this week could bump it out of the latter category (and, some critics say, the former one). The rule, announced Tuesday by Labor Secretary Thomas Perez, would extend federal minimum-wage and overtime laws to about two million home-health workers, beginning Jan. 1, 2015.

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Should that aide get time-and-a-half?

As Melanie Trottman and Kris Maher explain in The Wall Street Journal, home-health workers have long been excluded from minimum-wage protections due to a wrinkle in the Fair Labor Standards Act of 1974, which essentially put them in the same category as informally paid baby-sitters and domestic workers who provided “companionship workers.” These aides usually aren’t fully licensed medical pros—they’re more likely to focus on dressing, bathing and feeding the elderly and disabled. But the aides and their advocates have argued that their work is more demanding, and requires more skill, than the law recognizes.

Our country faces many challenges when it comes to meeting the long-term care needs of our older population, a need that will only grow as boomers age. But we’d be in an even bigger bind without the unpaid work of family caregivers, according to testimony this week by Lynn Feinberg, senior strategic policy adviser at the AARP Public Policy Institute, before the Congressional Commission on Long-Term Care.

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Family caregivers help loved ones grow old at home.

Two-thirds of all older people with disabilities who receive long-term care at home get their care exclusively from family caregivers, Feinberg testified. What’s this care worth, in monetary terms? The Congressional Budget Office estimated the economic value of family caregiving to people 65 and over at $234 billion for 2011, a sum far exceeding all paid long-term services and supports. Family caregivers are increasingly performing medical tasks once provided only by medical professionals, Feinberg testified, such as wound care and administering injections.

About Encore

Encore looks at the changing nature of retirement, from new rules and guidelines for financial security to the shifting identities, needs and priorities of people saving for and living in retirement. Our lead blogger is editor Matthew Heimer, and frequent contributors include editor Amy Hoak, writer Catey Hill, and MarketWatch columnists Elizabeth O’Brien, Robert Powell and Andrea Coombes. Encore also features regular commentary from The Wall Street Journal retirement columnists Glenn Ruffenach and Anne Tergesen and the Director of the Center for Retirement Research at Boston College, Alicia H. Munnell.